Abstract
This is an interesting article that suggests a policy change in the surgical treatment of type A dissections [1Panos A. Kalangos A. Christofilopoulos P. Khatchatourian G. Combined surgical and endovascular treatment of aortic type A dissection.Ann Thorac Surg. 2005; 80: 1087-1090Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar]. As the majority of cardiovascular surgeons use the “open distal” anastomotic technique, this prophylactic approach to close distal tears with endovascular stents in descending aorta seems reasonable. For type B dissections with retrograde dissection to the ascending aorta, this technique is appropriate and unique. The practical problems with routine use of this procedure are the necessity to identify true and false lumens and to know if there are visceral vessels arising from the false lumen. Closure of descending tears could exclude flow to false lumen and cause ischemia.
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